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MANAGED CARE

Medicaid managed care programs have been initiated nationwide during the last several years. The goals of these programs include:

• improved access for children to needed preventive, primary, specialty, and health-related services;

• assurance of quality care;

• satisfaction of consumers and providers with the health care delivery systems;

• quantitative evaluation processes such as measurement of individual and population-based health outcomes; and

• control of the spiraling costs of health care. Early consumer feedback about Medicaid managed care programs has been interpreted by lawmakers and state program directors to show improved satisfaction. This positive feedback is due to the benefits of allowing access to personal physicians, short-term cost savings, and systems to monitor the quality of care through physician credentialing, chart reviews and focused studies. However, the ultimate value to consumers, states and providers of inserting a business infrastructure between the government payer and the providers remains to be seen.